Digitization of healthcare: Where does Germany rank?

How far along is the digitization of the German healthcare system at the moment? It is an interesting question for both users and patients who can benefit directly from digitization and providers who plan to complement the German healthcare market with digitization products and solutions.

Sebastian Zilch’s presentation at the MEDICA CONNECTED HEALTHCARE FORUM at MEDICA 2022 gave insights into the subject. In this MEDICA-tradefair.com interview, he talks about the current state of digitization in the German healthcare system and explains how the German Federal Ministry of Health is planning to press forward on digital changes.

Mr. Zilch, how do you rate the current state of digitization in the German healthcare system?

Sebastian Zilch: Some readers may recall the 2018 study by the Bertelsmann Stiftung, which listed Germany in the second to last position in this setting. A lot has changed since then. Here are just a few examples: all German citizens covered by statutory health insurance are legally entitled to a national electronic patient record (ePA), allowing them to manage their own health data with sovereignty. For the past two years, digital health applications (DiGA) can be prescribed or reimbursed. Both patients and care providers are increasingly using this option. The pandemic has also accelerated the trend as everyone has come to appreciate the importance of digitization in healthcare as is evidenced by the number of video consultations, which has multiplied over the past three years.

What does the digitization strategy of the Federal Health Ministry aim to achieve?

Zilch: The digitization strategy for medical and health care will provide clarity and direction pertaining to the digitization in the healthcare sector for the coming years. It was and remains very important to us to incorporate and reflect the different perspectives and ideas from the medical and health care sector. All relevant stakeholders must be on the same page to make the strategy succeed. That's why I am very pleased to see that so many organizations and experts got involved in the strategic process. We are currently in the process of finalizing, which is why I do not want to get ahead of the results at this juncture.

Certain issues are already coming to the forefront: We need to focus less on technology and concentrate more on people and processes. Digital care processes must consistently put people center stage. We want to support the individual as a sovereign actor in a digitally supported health and care landscape by placing an increased focus on user-centric design when it comes to digital applications, for example. What’s more, relevant health information must be made available and simpler to use to yield benefits. The introduction of an opt-out process pertaining to the ePA plays a key role in this context.

What is the timetable for these goals? What are the key steps in the next few years?

Zilch: The strategy will be presented to the public in the first quarter of 2023. We all know that is when the real work begins. The implementation, evaluation, and update of the strategy can only succeed if all stakeholders make joint efforts and are on the same page. That is why it is so important to carefully consider and discuss the allocation of tasks, roles, and responsibilities as part of the strategy development.

Germany took an important step towards establishing digital health services when it launched the DiGA initiative in 2019. How do you rate the first three years of DiGA?

Zilch: It was a strenuous yet a very rewarding path. Since then, more than 30 digital applications are listed in the DiGA directory. They cover an increasing number of indications and provide therapy support for patients in a wide variety of ways. The Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte, BfArM) and the various other institutions involved in the DiGA process have acquired new knowledge, set up new networks and have embarked on a path of continuous improvement and development. Doctors are also increasingly interested in digital health applications. On this basis, we can now develop the topic and consider a broader scope of DiGA telehealth care scenarios in the future.

From your perspective, what obstacles must still be overcome and what improvements are necessary to advance digitization in healthcare?

Zilch: I have already indicated one key factor: namely, the acceptance and enthusiasm of those involved and affected – this includes insured persons, patients, people in need of care, service providers, healthcare professionals, payers in the health care industry, software providers and stakeholders from science. Without them, success in digital transformation in medical and health care will be difficult to achieve. What’s more, we must finally have a joint constructive conversation in Germany to find the right balance between valid data privacy and data security concerns and the equally valid interest in a greater use of health information as it pertains to patient protection and public health. Many countries have shown us different options on how to accomplish this.